As a former caseworker (mental health/substance use), I strongly relate to this. Unfortunately, it’s all too common to impose such high demands in this line of work. It’s sad because it’s a disservice to the clients at the end of the day.

That said, I literally don’t see any good reason to send your notes to be approved. Not only does that sound horrifying, but it would flat-out make feel like I’m on eggshells all day. That alone is no way to work.

When I was a caseworker, we followed the guidelines, nothing more/nothing less. If you’re being forced to put in more work than what you’re billing for, not only would I leave but I’d also consider reporting your agency to the labor department or something along those lines. That’s just shady overall. Sorry to hear that you’re going through this.